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PubMed1999

Determinants of caries prevalence and severity in higher SES Indian children.

OBJECTIVES: Recent epidemiological studies in the economically developing countries show that the prevalence and severity of dental caries has increased with industrialization and exposure of these populations to western diets. The aim of this study was to quantify the caries experience, and identify determinants associated with caries, in a population which has a higher socio-economic status (SES), and is the most westernized in India. BASIC RESEARCH DESIGN: The study site was Goa, a former Portuguese colony, which became part of India in 1961. Data came from a cross-sectional survey of 1,189 seventh grade children in private schools, consisting of a clinical dental examination and a self-administered questionnaire to their parents. MAIN OUTCOME MEASURES: The study used the cavitated/non-cavitated criteria to score for caries, the TF index for fluorosis, and the Silness and Loe index for plaque. RESULTS: The mean age of the children was 12.2 years. The proportion of children caries-free in the permanent dentition was 22.2%. The mean DMFT and DMFS in the study group were 2.78 and 4.20, respectively. The decayed component accounted for over 87% of the DMFT, DMFS, dft, and dfs. Results of the crude, stratified, and multivariate regression analyses showed that poor oral hygiene, mother's highest level of education, use of fluoride toothpaste before the age of six years, and higher frequency of tooth brushing were risk indicators of caries prevalence and severity. CONCLUSION: The findings suggest that risk indicators of caries in this study population were similar to those in developed countries.

Child↗
PubMed2005

Alternatives for the treatment and disposal of healthcare wastes in developing countries.

Waste production in healthcare facilities in developing countries has brought about a variety of concerns due to the use of inappropriate methods of managing the wastes. Inappropriate treatment and final disposal of the wastes can lead to adverse impacts to public health, to occupational health and safety, and to the environment. Unfortunately, most economically developing countries suffer a variety of constraints to adequately managing these wastes. Generally in developing countries, few individuals in the staff of the healthcare facility are familiar with the procedures required for a proper waste management program. Furthermore, the management of wastes usually is delegated to poorly educated laborers who perform most activities without proper guidance and insufficient protection. This paper presents some of the most common treatment and disposal methods utilized in the management of infectious healthcare wastes in developing countries. The methods discussed include: autoclave; microwave; chemical disinfection; combustion (low-, medium-, and high-technology); and disposal on the ground (dump site, controlled landfill, pits, and sanitary landfill). Each alternative for treatment and disposal is explained, including a description of the types of wastes that can and cannot be treated. Background information on the technologies also is included in order to provide information to those who may not be familiar with the details of each alternative. In addition, a brief presentation of some of the emissions from each of the treatment and disposal alternatives is presented.

Developing Countries↗
PubMed1997

Women's health. The childbearing years and after.

Health and development planners have tended to see women primarily in context of their reproductive role. As a result, solutions to women's health needs have been restricted to expanding and improving maternal and child health systems. There has recently been a major shift in direction, largely because of the influence of the world conference on population and development held in Cairo in 1994. Dr Guiseppe Benagiano, director of the special programme of research, development and research training in human reproduction based at the WHO, says, "We need to remind ourselves constantly that reproductive health is not simply a biomedical issue but one with serious implications for our general health and by extension, for all our efforts in human social and economic development." The 1993 world development report on health identified the lack of a clear strategy for engaging women in health care and suggested that child health services, prenatal care, treatment of sexually transmitted diseases, and family planning services should be provided jointly at convenient times. In an example of this, the Chilean Institute of Reproductive Medicine now offers integrated family planning services at the same time as child health services, and Thailand is experimenting with mobile health clinics to reach women in their homes. As the proportion of elderly women increases, old age is increasingly being seen as a female issue. With the impact of urbanisation and industrialisation, more of these women are living isolated lives, often suffering from chronic debilitating diseases. In his opening statement to the global commission on women's health in April 1995 which focused on health conditions of women in old age, Dr Hiroshi Nakajima, the WHO's director general, said: "Our goal should not be solely to extend lives in the physical sense, but to ensure that the added years are worth living."

Alcohol Drinking↗
PubMed1994

Why do levels of human welfare vary among nations?

This article investigates what factors explain the wide differences in human welfare among nations. Applying the theory of human need developed by Doyal and Gough, the authors construct a series of indicators of need satisfaction and use these to map contemporary national levels of welfare. They criticize past cross-national studies of welfare outcomes for using a single index of welfare, usually the Physical Quality of Life Index. A comprehensive model of national differences in need satisfaction is then developed. Seven theories are deployed and are tested against the evidence using path analysis, which permits different causal patterns to be simultaneously considered. The authors conclude that per capita incomes are only one of several factors explaining cross-national variations in need satisfaction: the degree of economic and political independence, the extent of democracy and human rights, the capacity and dispositions of the state, and relative gender equality all positively and independently affect a nation's level of welfare. Economic development alone cannot guarantee social development.

Cross-Cultural Comparison↗
PubMed2005

[Nuclear medicine: medical technology research].

UNLABELLED: AIM, METHOD: The scientific publications in the 2003 and 2004 issues of the journal Nuklearmedizin were analyzed retrospectively with regard to the proportion of medical technology research. RESULTS: Out of a total of 73 articles examined, 9 (12%) were classified as medical technology research, that is, 8/15 of the original papers (16%) and one of the case reports (5%). Of these 9 articles, 44% (4/9) focused on the combination of molecular and morphological imaging with direct technical appliance or information technology solutions. CONCLUSION: Medical technology research is limited in the journal's catchment area. The reason for this is related to the interdependency between divergent development dynamics in the medical technology industry's locations, the many years that the area of scintigraphic technology has been underrepresented, research policy particularly in discrepancies in the promotion of molecular imaging and a policy in which health is not perceived as a predominantly good and positive economic factor, but more as a curb to economic development.

Germany↗
PubMed1978

[Social psychiatry of migrant workers (author's transl)].

A review of literature about psychic illness in migrant workers (with special reference to the situation in Europe) is presented, including the problems of incidence and prevalence, course of the illness, typical syndromes and treatment. Results concerning incidence and prevalence of psychic disease in migrant workers are contradictory and partly--for methodological reasons--of questionable quality. It cannot be take for granted, that migrant workers suffer more often from psychiatric disturbances than either of the two possible control groups: the populations of the emigration or immigration countries respectively. There are two high risk periods for migrants: shortly after the migration and after a longer period in the guest country. Differences between the migrant's culture and that of the immigration context (language, mythical beliefs, illness behavior) influence the manifestations of psychiatric syndromes. The following syndromes are typical for migrant workers: paranoid reactions, hypochondric-depressive syndromes, psychosomatic conditions and sexual neurosis. Special attention requests the treatment of migrant workers with psychiatric problems; the aspects of psychotherapy, accompanying social measures and the return as therapeutic measure are discussed. In the second part, a general frame of reference for the sociological analysis of the problem of migrant workers is presented. Reasons for the mass immigration of foreign workers to the industrialized countries of central Europe were the demand of labor force and the large gap in socio-economic development between the countries. In the immigration context, the foreign workers find themselves in the lowest social strata and numerous problems accumulate there. Empirical evidence for different sociological explanations of mental illnes of migrant workers ist presented: hypotheses of social selection vs. social causation (low socio-economic status, goal-striving-stress, culture-shock theory, theory of culture change and isolation hypothesis).

Adjustment Disorders↗
PubMed1978

Nutrition, development, and foreign aid: a case study of U.S.-directed health care in Colombian plantation zone.

Based on a case study of some aspects of Rockefeller and USAID intervention in the Cauca Valley, Colombia, this article is aimed at drawing attention to the political characteristics and inadequacies of U.S.-sponsored health care planning and research in the Third World, particularly as regards nutrition in rural regions of intensive economic development. By contrasting an historical analysis of the politicoeconomic development of agriculture and nutrition in the southern Cauca Valley with the assumptions guiding U.S. intervention in the health field there, a more complete picture of the causes of malnutrition is obtained, among which should be counted the intervention of the U.S. itself. Inter alia, other approaches to the malnutrition problem are suggested.

Agriculture↗
PubMed2002

The West's moral obligation to assist developing nations in the fight against HIV/AIDS.

The HIV/AIDS epidemic is increasingly a disease of the disadvantaged, a destroyer of nations, and a threat to global security and well-being. But this need not be so: the world has the scientific knowledge, technological innovations, and financial resources to significantly reduce the spread and suffering caused by the disease. This paper argues that the wealthy nations of the world, led by the United States, have a moral obligation to offer much greater assistance to developing countries where the epidemic is most severe. Using Zimbabwe as a case study, this essay examines the immediate and underlying factors behind the epidemic in order to make realistic and affordable policy recommendations that include new investments in global health care, debt relief, and long-term economic development. By demonstrating our ability to dramatically affect the future course and consequences of this unprecedented epidemic, the paper concludes that greater action is not only in the interest of public health, but is also a moral imperative. By investing the necessary resources to improve public health and to reduce global poverty, we promote and extend the fundamental rights and values that we profess to hold dear.

Communicable Disease Control↗
PubMedDate not supplied

[Demography of aging in Spain].

In this article, the demography of the elderly in Spain is scrutinized. The older population from 1960 to 1991 and their presumed development for the period from 2001-2020 is analyzed. According to these data, we attempt to determine the influence on life situation of older people according to several factors, such as changes of family structures and intergenerational relations as well as changes in social stereotypes, expected political and economical developments, and new concepts in medical care. In closing, we raise questions about the necessary future living structures in Spain.

Aged↗
PubMed1997

Classification, prevalence, prevention and rehabilitation of intellectual disability: an overview of research in the People's Republic of China.

The People's Republic of China is a developing country with all the problems and challenges that face such countries all over the world. Progress has been hampered by scarcity of resources, and a lack of relevant information and appropriate skills, as well as by the stigma traditionally attached to people with intellectual disability. The present rapid economic development has made possible further improvement and expansion of educational opportunities, and health and rehabilitation services. According to a recent census and sample surveys conducted in the People's Republic of China, the overall prevalence rate of people with disabilities was estimated to 4.9%. Thus, China has more individuals with disabilities than any other country in the world. According to these figures, the prevalence of intellectual disability in the population is approximately 1%. For children younger than 14 years of age, the prevalence is around 2%, which accounts for 66% of all handicapped children, making it the most frequent childhood disability. Today, the existing medical facilities, and educational and social welfare organizations cannot meet the tremendous need of care and services. The problems of the large number of disabled children and adults are a major challenge for contemporary Chinese society. This paper is devoted to research pertinent to intellectual disability in China. With a few exceptions, only publications in the English language were included in this review, which makes the overview selective rather than comprehensive. Publications on classification systems and diagnostic criteria, screening methods and assessment instruments, prevalence rates, aetiology and risk factors, prevention and intervention efforts, special education, and families with children with intellectual disability are presented.

Adaptation, Psychological↗
PubMed2004

Child nutrition in developing countries.

Malnutrition permeates all aspects of health, growth, cognition, motor and social development of young children in developing countries. More than 50% of deaths in these children can be attributed to malnutrition, most often in conjunction with serious infection. Irreversible and lifelong sequelae prevent children from reaching their full potential. Child survival initiatives and programs have accomplished much to save the lives of children from common and preventable illnesses, but the quality of the survivors' health needs to be improved, with much more attention paid to nutrition of the preschool and school child. Promotion of nutritional health must become an integral part of primary health services, especially for infants, preschoolers, schoolchildren, and women. Promotion of exclusive breastfeeding and appropriate complementary feeding and weaning are essential inputs. A daunting challenge is to improve diet quality through the raising and consumption of small animals by rural subsistence households to enhance maternal and child nutrition. School feeding from preschool onward must be an integral part of education so children are in a condition to learn. An excellent example of such programs is the WHO initiated Integrated Management of Childhood Illness, which integrates nutrition into the care of both sick and well children. The Early Child Development Program initiated by the World Bank and UNICEF has taken hold in many countries. Nutrition outcomes are closely linked with health and education activities starting in the preconception period through pregnancy, lactation, and childhood. Investment in human capital early in life will optimize the growth and social and economic development of children, families, and communities.

Anemia, Iron-Deficiency↗
PubMed1997

Fundamentals of modern telemedicine in Africa.

The FOMTA (Fundamentals of Modern Telemedicine in Africa) project aims to promote the development of indigenous regional networks between R&D centres and universities of the Developing Countries (DCs) and their European counterparts. While FOMTA prepares the way for the use of broadband technology in Africa, it will also associate the DCs with the generation of knowledge, innovative and appropriate technologies needed to solve some of the specific problems, in order to achieve a sustainable economic development. Designed to eliminate the time-delaying lack of infrastructure, FOMTA will embark on the simulation of the integrated Service Digital Network infrastructure. FOMTA will adopt measures to increase the awareness and stimulate the participation of the DCs in the telemedicine and health care telematics projects through demonstrations, pilot projects, workshops, training and exchange activities. This will demonstrate the feasibility of telemedicine services in the DCs, including trial of services in real-life circumstances, and will provide training possibilities for researchers in the use of methods and tools for advanced communication technologies and telematics. Undoubtedly, telediagnosis, teleconsultation and other areas of telemedicine would thrive in Africa both as remote testing grounds and fields of practical applications.

Africa↗
PubMed2001

Health care for older persons: a country profile--Lebanon.

Lebanon is a small country, comparable in size to New Hampshire. It is currently estimated that 8% of the population is age 65 and older. The Lebanese population has witnessed a clear demographic transition in the past few decades. Our culture demands respect for older people and values highly the natural bonds of affection between all members of the family. The healthcare system in the country is an adaptation of the European model. Despite the large number of physicians (approximately 10,000) there is a shortage of primary care and geriatric physicians. There are 36 nursing homes in Lebanon, with a total of 6,000 beds, but most of them are understaffed, with the exception of three nursing homes that offer relatively comprehensive services including rehabilitative, preventive, and curative services. The Ain Wizen Elderly Care Centre is well recognized for the program it operates for older people, which is a good model for the region and for Lebanon in terms of services, training, and research. Demographic changes and social and economic developments in Lebanon have created new realities in the unprecedented growth of the older population. Lebanon, like other developing countries, needs to define the policies and programs that will reduce the burden of an aging population on its society and economy. There is a need to ensure the availability of health and social services for older persons and to promote older persons' continuing participation in a socially and economically productive life.

Aged↗